Association Between Culture-Negative Versus Culture-Positive Sepsis and Outcomes of Patients Admitted to the Pediatric Intensive Care Unit

Hazwani, Tarek R; Kazzaz, Yasser; Alsugheir, Shaden; Aldelaijan, Shahad; Alsugheir, Futoon; Alali, Hamza; Alsadoon, Alaa; Alhamwah, Moudi; Alsubaiel, Sara; Alomar, Bassam; Vishwakarma, Ramesh

doi:10.7759/cureus.9981

Cited by 20 publications

(22 citation statements)

References 21 publications

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“…2016 All-cause Single-center, retrospective cohort study 80 42 38 Kethireddy et al [ 19 ] 2018 Canada, USA, Saudi Arabia Jan. 1997–Dec. 2010 Hospital Multicenter, retrospective cohort study 8670 2651 6019 Sigakis et al [ 20 ] 2019 USA Jan. 2007–May 2014 Hospital Single-center, retrospective cohort study 10,393 9288 1105 Hazwani et al [ 21 ] 2020 Saudi Arabia Apr. 2015–Jan.…”

Section: Resultsmentioning

confidence: 99%

Comparison of culture-negative and culture-positive sepsis or septic shock: a systematic review and meta-analysis

Guo

Yang

et al. 2021

Crit Care

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Background Mortality and other clinical outcomes between culture-negative and culture-positive septic patients have been documented inconsistently and are very controversial. A systematic review and meta-analysis was performed to compare the clinical outcomes of culture-negative and culture-positive sepsis or septic shock. Methods We searched the PubMed, Cochrane and Embase databases for studies from inception to the 1st of January 2021. We included studies involving patients with sepsis or septic shock. All authors reported our primary outcome of all-cause mortality and clearly compared culture-negative versus culture-positive patients with clinically relevant secondary outcomes (ICU length of stay, hospital length of stay, mechanical ventilation requirements, mechanical ventilation duration and renal replacement requirements). Results were expressed as odds ratio (OR) and mean difference (MD) with accompanying 95% confidence interval (CI). Results Seven studies including 22,655 patients were included. The primary outcome of this meta-analysis showed that there was no statistically significant difference in the all-cause mortality between two groups (OR = 0.95; 95% CI, 0.88 to 1.01; P = 0.12; Chi-2 = 30.71; I2 = 80%). Secondary outcomes demonstrated that there was no statistically significant difference in the ICU length of stay (MD = − 0.19;95% CI, − 0.42 to 0.04; P = 0.10;Chi-2 = 5.73; I2 = 48%), mechanical ventilation requirements (OR = 1.02; 95% CI, 0.94 to 1.11; P = 0.61; Chi2 = 6.32; I2 = 53%) and renal replacement requirements (OR = 0.82; 95% CI, 0.67 to 1.01; P = 0.06; Chi-2 = 1.21; I2 = 0%) between two groups. The hospital length of stay of culture-positive group was longer than that of the culture-negative group (MD = − 3.48;95% CI, − 4.34 to − 2.63; P < 0.00001;Chi-2 = 1.03; I2 = 0%). The mechanical ventilation duration of culture-positive group was longer than that of the culture-negative group (MD = − 0.64;95% CI, − 0.88 to − 0.4; P < 0.00001;Chi-2 = 4.86; I2 = 38%). Conclusions Culture positivity or negativity was not associated with mortality of sepsis or septic shock patients. Furthermore, culture-positive septic patients had similar ICU length of stay, mechanical ventilation requirements and renal replacement requirements as those culture-negative patients. The hospital length of stay and mechanical ventilation duration of culture-positive septic patients were both longer than that of the culture-negative patients. Further large-scale studies are still required to confirm these results.

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Section: Resultsmentioning

confidence: 99%

Comparison of culture-negative and culture-positive sepsis or septic shock: a systematic review and meta-analysis

Guo

Yang

et al. 2021

Crit Care

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“…61 The gold standard for diagnosing sepsis is blood culture, however, cultures can take hours to days to yield results and up to 87% of pediatric sepsis cases are blood culture-negative. 62,63 A benefit to metabolomics is that very small volume samples can be analyzed in less than an hour. 6 One of the earliest studies that used metabolomics for pediatric sepsis focused on differentiating between septic shock and systemic inflammatory response syndrome (SIRS) and predicting mortality (Table 4).…”

Section: Pneumoniamentioning

confidence: 99%

Metabolomics in pediatric lower respiratory tract infections and sepsis: a literature review

et al. 2022

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Lower respiratory tract infections (LRTIs) are a leading cause of morbidity and mortality in children. The ability of healthcare providers to diagnose and prognose LRTIs in the pediatric population remains a challenge, as children can present with similar clinical features regardless of the underlying pathogen or ultimate severity. Metabolomics, the large-scale analysis of metabolites and metabolic pathways offers new tools and insights that may aid in diagnosing and predicting the outcomes of LRTIs in children. This review highlights the latest literature on the clinical utility of metabolomics in providing care for children with bronchiolitis, pneumonia, COVID-19, and sepsis.

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“…The search strategy identi ed 235 studies, and the data were from seven cohort studies comprising 22655 patients (Table 2) [16][17][18][19][20][21][22]. The characteristics of the included studies are shown in Table 2.…”

Section: Study Characteristicsmentioning

confidence: 99%

Comparison of Culture-Negative and Culture-Positive Sepsis or Septic Shock: A Systematic Review and Meta-Analysis

Guo

Yang

et al. 2021

Preprint

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Background: Mortality and other clinical outcomes between culture-negative and culture-positive septic patients have been documented inconsistently and are very controversial. A systematic review and meta-analysis was performed to compare the clinical outcomes of culture-negative and culture-positive sepsis or septic shock.Methods: We searched the PubMed, Cochrane, and Embase databases for studies from inception to the 1st of January 2021. We included studies involving patients with sepsis or septic shock. All authors reported our primary outcome of all-cause mortality and clearly comparing culture-negative versus culture-positive patients with clinically relevant secondary outcomes (ICU length of stay, hospital length of stay, mechanical ventilation requirements, mechanical ventilation duration and renal replacement requirements). Results were expressed as odds ratio (OR) and mean difference (MD) with accompanying 95% confidence interval (CI).Results: Seven studies including 22655 patients were included. The primary outcome of this meta-analysis showed that there was no statistically significant difference in the all-cause mortality between two groups (OR=0.95; 95% CI, 0.88 to 1.01; P=0.12; Chi2=30.71; I2=80%) . Secondary outcomes demonstrated that there was no statistically significant difference in the ICU length of stay(MD=-0.19;95% CI, -0.42 to 0.04; P=0.10;Chi2=5.73; I2=48%), mechanical ventilation requirements(OR=1.05; 95% CI, 0.93 to 1.18; P=0.41; Chi2=5.89; I2=66%) and renal replacement requirements(OR=0.82; 95% CI, 0.67 to 1.01; P=0.06; Chi2=1.21; I2=0%) between two groups. The hospital length of stay of culture-positive group was longer than that of the culture-negative group(MD=-3.48;95% CI, -4.34 to -2.63; P<0.00001;Chi2=1.03; I2=0%). The mechanical ventilation duration of culture-positive group was longer than that of the culture-negative group(MD=-0.64;95% CI, -0.88 to -0.4; P<0.00001;Chi2=4.86; I2=38%).Conclusions: Culture positivity or negativity was not associated with mortality of sepsis or septic shock patients. Furthermore, culture-positive septic patients had similar ICU length of stay, mechanical ventilation requirements and renal replacement requirements as those culture-negative patients. The hospital length of stay and mechanical ventilation duration of culture-positive septic patients were both longer than that of the culture-negative patients. Further large-scale studies are still required to confirm these results.

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Association Between Culture-Negative Versus Culture-Positive Sepsis and Outcomes of Patients Admitted to the Pediatric Intensive Care Unit

Cited by 20 publications

References 21 publications

Comparison of culture-negative and culture-positive sepsis or septic shock: a systematic review and meta-analysis

Comparison of culture-negative and culture-positive sepsis or septic shock: a systematic review and meta-analysis

Metabolomics in pediatric lower respiratory tract infections and sepsis: a literature review

Comparison of Culture-Negative and Culture-Positive Sepsis or Septic Shock: A Systematic Review and Meta-Analysis

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